Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.33 / $89.99 / $370.27	Facility		$74.33	$89.99	$370.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.66 / $88.13 / $209.73	Professional		$63.66	$88.13	$209.73
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $145.34 / $145.34 / $145.34	Professional	25	$145.34	$145.34	$145.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $124.24 / $124.24 / $124.24	Professional		$124.24	$124.24	$124.24
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $94.26 / $113.97 / $300.14	Facility		$94.26	$113.97	$300.14
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $82.36 / $114.50 / $203.95	Professional		$82.36	$114.50	$203.95
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $92.60 / $192.78 / $256.70	Facility		$92.60	$192.78	$256.70
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $77.25 / $89.60 / $146.74	Professional		$77.25	$89.60	$146.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.04 / $109.25 / $250.32	Professional		$60.04	$109.25	$250.32
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $150.00 / $212.34	Professional		$100.00	$150.00	$212.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $78.94 / $121.18 / $210.46	Professional		$78.94	$121.18	$210.46
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $407.21 / $441.13 / $441.13	Facility		$407.21	$441.13	$441.13
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $569.78 / $569.78 / $830.18	Professional		$569.78	$569.78	$830.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $60.00	Professional		$32.34	$32.34	$60.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $72.56 / $109.79 / $176.84	Facility		$72.56	$109.79	$176.84
Providence Facility/Professional Professional Modifier Low / Median / High Price $68.04 / $117.76 / $240.80	Professional		$68.04	$117.76	$240.80
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $136.63 / $136.63 / $241.26	Professional		$136.63	$136.63	$241.26
United Facility/Professional Professional Modifier Low / Median / High Price $66.56 / $94.71 / $248.72	Professional		$66.56	$94.71	$248.72